Muscat J E, Wynder E L
Division of Epidemiology, American Health Foundation, New York, NY 10017, USA.
Environ Health Perspect. 1995 Sep;103(9):812-8. doi: 10.1289/ehp.95103812.
The risk of lung cancer associated with diesel exhaust has been calculated from 14 case-control or cohort studies. We evaluated the findings from these studies to determine whether there is sufficient evidence to implicate diesel exhaust as a human lung carcinogen. Four studies found increased risks associated with long-term exposure, although two of the four studies were based on the same cohort of railroad workers. Six studies were inconclusive due to missing information on smoking habits, internal inconsistencies, or inadequate characterization of diesel exposure. Four studies found no statistically significant associations. It can be concluded that short-term exposure to diesel engine exhaust (< 20 years) does not have a causative role in human lung cancer. There is statistical but not causal evidence that long-term exposure to diesel exhaust (> 20 years) increases the risk of lung cancer for locomotive engineers, brakemen, and diesel engine mechanics. There is inconsistent evidence on the effects of long-term exposure to diesel exhaust in the trucking industry. There is no evidence for a joint effect of diesel exhaust and cigarette smoking on lung cancer risk. Using common criteria for determining causal associations, the epidemiologic evidence is insufficient to establish diesel engine exhaust as a human lung carcinogen.
已根据14项病例对照研究或队列研究计算出与柴油废气相关的肺癌风险。我们评估了这些研究的结果，以确定是否有足够的证据表明柴油废气是一种人类肺癌致癌物。四项研究发现长期接触柴油废气会增加风险，不过这四项研究中有两项是基于同一组铁路工人。六项研究由于缺乏吸烟习惯信息、内部不一致或柴油暴露特征描述不充分而没有定论。四项研究未发现具有统计学意义的关联。可以得出结论，短期接触柴油发动机废气（<20年）对人类肺癌没有致病作用。有统计学但非因果证据表明，长期接触柴油废气（>20年）会增加机车工程师、制动工和柴油发动机机械师患肺癌的风险。关于长期接触柴油废气对运输行业的影响，证据并不一致。没有证据表明柴油废气和吸烟对肺癌风险有联合作用。根据确定因果关联的通用标准，流行病学证据不足以将柴油发动机废气确定为人类肺癌致癌物。
